HomeMy WebLinkAboutPlg Permit 01-1284
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
ENGLISH, DENNIS
6773 BOUDIN STREET NORTHEAST
PRIOR LAKE, MN 55372
(952) 447-7635
I. Blue File
2. Gold City
1 Yellow Applicant
I PERMIT NO'O/_IJ-fyrl
I
ZONING (office use)
d.-s-fJ
LEGAL DESCRIPTION (office use only)
LO~- BLOCK ^ ADDITION
OWNER
(Name)
(Address)
verniS EngLish
~tuJ
(Phone)
APPLICANT
(Name)
(Address)
NORBlOM PLUMBING CO.
~ 827~033
2 r~ARFIELD AVE. SO.
MINNEAPOLIS, MN 55408
(Phone)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE IOlal/OI
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher , Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (I or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly .Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $ LtDO
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Paid $ Lf tJ, .--
Date ! _ q _I
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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DATE TillE
CITY OF PRIOR LAKE .1:-/ D
INSPECTION NOTICE SCHEDULED
ADDRESS :3
OWNER CONTR.
PHONE NO. PERMIT NO.
D FOOTING D PLUMBING RI D EXIGRAD/FILLlNG
D FOUNDATION D MECH RI D COMPLAINT
D FRAMING D WATER HOOKUP D FIREPLACE RI
D INSULATION D SEWER HOOKUP D FIREPLACE FINAL
D FINAL FINAL D GAS LINE AIR TST
D SITE INSPECTIO D MECH FINAL D
COMMENTS:
c' 1 QY--
~;~
pORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT. ~~ CALL FO~ RElNSPECTION BEFORE COVERING
Inspector: ~ 3- {() fI7 Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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